The way and manner in which the Nigerian Medical Association is going about lobbying the federal government to implement their own version of the Public-Private Partnership (PPP) is at best a lullaby on the President of Nigeria to condition the government to a sleep mode thereby paving way to whole scale corruption in the Nigerian health sector to the anguish of Nigerian masses. The version of the PPP being paraded by the NMA is definitely not the way out of the mismanagement and maladministration of the human and material resources in the health sector. It is, in clear terms a decorated conduit for siphoning the Internally Generated Revenue (IGR) from the various departments in the hospitals.
For the purpose of public enlightenment, the PPP has the following aims:
- To leverage the government on the huge financial burden involved in running the health sector.
- To reduce the cost of healthcare delivery aimed at increasing quality of care without much financial pressure on patients. In other words, discouraging the out-of-pocket financing of health care services by Nigerians
- To ensure the five year balance between the time of investment by partners and time of business maturity is maintained if not shortened.
- To improve personnel development, professionalism through training and retraining of professionals to meet the demands of modern health care delivery.
- To enhance equipment and infrastructural base, innovation, character, staff and patient safety at workplace.
- To avoid excessive charges of services rendered in all departments of the hospital
Unfortunately, the call for the implementation of PPP by NMA in all facets of the health sector is merely self-seeking, idiosyncratic and egocentric that should be treated as a pungent hogwash. This is because it is a paranoid and unrealistic approach to the problems submerging the growth of the health sector in Nigeria. The NMA in their skewed presentations have again projected themselves the gluttonous power drunks we have always seen. They must know that they have nothing to fear by not heading hospital administration as that will afford them time to concentrate more on their core professional competence. In my opinion and experience so far, the call for PPP by Nigerian doctors in our health system is:
- To keep mismanaging the IGR by indirectly giving out other departments to their friends and associates.
- To promote financial recklessness marked by impunity as we witnessed recently in FMC Owerri, Imo state.
- To relegate professionalism and promote quackery in the pursuit of cheap labour.
- To create a system that will easily evade the conventional regulations of statutory professional bodies such as MLSCN and PSN
- To create private clinical services in government owned hospitals thereby creating inequality in a system where Nigerians would be easily short changed.
If this is left unchecked, one day the NMA will be canvassing to head the Directorate of Private Clinical Services (DPCS), and every other organisation under the health sector.
Nigerians should permit me to say that the income from private medical service or private clinical service may not always be accounted for, because everything from the beginning to the end of the private service, the patient pays double of what he or she should have paid, all at the expense of the same hospital staff.
The great challenge therefore is that:
- The NMA has succeeded in telling Nigerians how PPP will improve other departments allied to medicine ( such as laboratory, pharmacy, radiology, records, physiotherapy, nursing) as seen in LUTH, Federal Staff Hospital, Abuja, the unfortunate case in FMC Owerri, and the case of Neuropsychiatry Hospital, Enugu state. However, NMA has failed to tell Nigerians how PPP will fare in basic medical departments (such as theatre/ surgery, O&G, paediatrics &geriatrics, cadiology, neurology, ENT, medicine, family medicine, nephrology, hepatology, orthopaedics). Nigerians must know how application of PPP in the core medical departments will reduce the unquantifiable capital lost in medical tourism by Nigerians to America, Europe and India in search of better health management system.
- NMA should not forget to tell Nigerians where the health system in Nigeria is heading to. We know that before decree 1985 when health managers were heading the hospitals, our health system was among the first twenty in the world. Today, where are we with the NMA in-charge of hospital administration? NMA please tell Nigerians
- PPP as a policy in general cannot thrive in a corrupt system.
- PPP is born out of pride, quest for monopoly and the unjustifiable fear of losing relevance in the event of rotational headship of hospitals with other health professionals who constitute about 95% of health force in Nigeria.
- The NMA should forget about this lullaby on President Muhammadu Buhari with the corruption-prone PPP as the democratic General is not buying into their intended sedative and seductive touches to re-engineer the corruption conduit the president is trying hard to dismantle. They should allow him fashion out a corruption-free approach to implementing the PPP by involving the stakeholders in the health sector.
BY Anyanwu, Ebere (Chemical Pathologist)